不同生理阶段女性阴道微生态状况分析  

Female vaginal microecology in different physiological stages

作　　者：段文冰[1] 王子娥[1] 鞠瑛[1] 张璐璐[1] 刘义刚[1] 唐闻[1] 刘芸[1] DUAN Wenbing;WANG Zi＇e;JU Ying;ZHANG Lulu;LIU Yigang;TANG Wen;LIU Yun(Department of Laboratory Medicine,Shandong Provincial Hospital Affiliated to Shandong University,Jinan,Shandong 250021,China)

机构地区：[1]山东大学附属省立医院医学检验部,山东济南250021

出　　处：《中国微生态学杂志》2018年第10期1211-1216,共6页Chinese Journal of Microecology

基　　金：山东省自然科学基金(ZR2016HM52);山东省自然科学基金(ZR2014HP043);山东省科学技术发展计划(2014GGH218041);山东省临床重点专科建设项目(鲁卫医字2013-26)

摘　　要：目的通过对女性阴道微生态的检查,全面评估不同生理阶段的女性阴道微生态状况,为临床对女性阴道感染性疾病的诊断和治疗提供较全面客观的实验室依据。方法选取2017年1月1日至2017年6月30日在山东省立医院妇产科门诊就诊的女性患者2311例,分别采集患者的阴道分泌物,通过相差显微镜、革兰染色和干化学检测等方法,分别对患者阴道分泌物的清洁度、菌群密集度、多样性,pH值、AV评分、Nugent评分和功能评价等进行分析。结果 (1)2311例患者中育龄期患者组1806例,围绝经期患者组380例,老年绝经期患者组125例,其中育龄期患者组阴道优势菌为G+大杆菌(26.57%,480/1806),菌群密集度(+++/++++,76.97%,1390/1806)、菌群多样性(++/+++,27.96%,505/1806)与围绝经期患者组和老年绝经期患者组比较,差异均有统计学意义(Ps<0.01)。围绝经期患者组阴道清洁度(Ⅲ/Ⅳ度,50.26%,191/380),pH值(pH≥4.6,72.89%,277/380),菌群密集度(未见,3.42%,13/380),过氧化氢(+,84.74%,322/380),唾液酸苷酶(+-,14.21%,54/380;+,27.89%,106/380),与育龄期患者组比较,差异均有统计学意义(Ps<0.01);围绝经期患者组阴道优势菌为G-小杆菌(20.26%,77/380),革兰染色不定球杆菌(27.10%,103/380)、菌群多样性(+,78.16%,297/380)与育龄期患者组和老年绝经期患者组比较,差异均有统计学意义(Ps<0.01)。老年绝经期患者组阴道pH值(pH≥4.6,85.60%,107/125),无优势菌(25.60%,32/125)、优势菌为G+球菌(39.20%,49/125),菌群密集度(未见,20.80%,26/125;+/++,48.80%,61/125),菌群多样性(未见,20.80%,26/125)、白细胞酯酶(+,77.60%,97/125),与育龄期患者组和围绝经期患者组比较,差异均有统计学意义(Ps<0.01)。(2)老年绝经期患者组AV (中度,17.6%,22/125;重度,5.6%,7/125)、BV (中介,56%,70/125)均显著高于育龄期患者组和围绝经期患者组;育龄期患者组VVC (23.20%,419/1806)和CV (8.47%,153/1806)的发病率均显著高于围绝经期患者组和Objective To evaluate vaginal microecological conditions of females in different physiological stages and provide laboratory evidence for clinical diagnosis and treatment.Methods 2,311 female patients who visited our gynecological department from January 1,2017 to June 30,2017 were enrolled.The specimens of vaginal secretions were collected.Vaginal cleanness,flora intensity and diversity,AV scores,Nugent scores and functional evaluation were assessed by using phase-contrast microscope,Gram staining and dry chemical test.Results（1）The patients were divided into reproductive age group（n=1,806）,perimenopause group（n=380）and elderly group（n=125）respectively.There were significant differences in vaginal dominant bacteria,G＋bacilli（26.57%,480/1806）,vaginal flora intensity（＋ ＋ ＋/＋ ＋ ＋ ＋,76.97%,1390/1806）and bacterial diversity（＋＋/＋＋＋,27.96%,505/1806）between the reproductive age group and the other two groups respectively（Ps〈0.01）.There were significant differences in vaginal cleanliness（III/IV,50.26%,191/380）,pH value（pH≥4.6,72.89%,277/380）,flora intensity（not seen,3.42%,13/380）,hydrogen peroxide（＋,84.74%,322/380）and sialidase（＋-,14.21%,54/380;＋,27.89%,106/380）between the perimenopause group and the reproductive age group（Ps〈0.01）.The dominant bacteria in the perimenopause group were G-xylobacilli（20.26%,77/808）and Gram variable coccobacilli（27.10%,103/380）,and the diversity of bacteria（＋,78.16%,297/380）was significantly different from that in the other two groups respectively（Ps〈0.01）.In the elderly group,the vaginal pH value（pH≥4.6,85.60%,107/125）,no dominant bacteria（25.60%,32/125）,dominant bacteria G＋cocci（39.20%,49/125）,bacterial density（not seen,20.80%,26/125;＋/＋＋,48.80%,61/125）,flora diversity（not seen,20.80%,26/125）,hydrogen peroxide（＋,91.2%,114/125）and leukocyte esterase（＋,77.60%,97/125）were statistically different from those in the other two groups respecti

关 键 词：阴道微生态 围绝经期 育龄期 老年绝经期 

分 类 号：R711.31[医药卫生—妇产科学]